Navigation Links
Evidence insufficient to recommend routine antibiotics for joint replacement patients
Date:12/18/2012

Rosemont, Ill. - The American Academy of Orthopaedic Surgeons (AAOS), and the American Dental Association (ADA) found that there is insufficient evidence to recommend the routine use of antibiotics for patients with orthopaedic implants to prevent infections prior to having dental procedures because there is no direct evidence that routine dental procedures cause prosthetic joint infections.

The AAOS and ADA's recommendations are based on a collaborative evidence-based clinical practice guideline that focuses on the possible linkage between orthopaedic implant infection and patients undergoing dental procedures.

"As clinicians, we want what is in the best interest of our patients, so this clinical practice guideline is not meant to be a stand-alone document. Instead it should be used as an educational tool to guide clinicians through treatment decisions with their patients in an effort to improve quality and effectiveness of care," said David Jevsevar, MD, MBA, chair of the AAOS Evidence Based Practice Committee which oversees the development of clinical practice guidelines.

"It has been long debated that patients with orthopaedic implants, primarily hip and knee replacements, are prone to implant infections from routine dental procedures," added Dr. Jevsevar who also is an orthopaedic surgeon in St. George, Utah. "What we found in this analysis is that there is no conclusive evidence that demonstrates a need to routinely administer antibiotics to patients with an orthopaedic implant, who undergo dental procedures.

  • In 2010, there were more than 302,000 hip replacement and 658,000 knee replacement procedures performed in the United States.[1]

  • Infections can occur when foreign organisms enter the wound during or at any point following joint replacement, and can lead to additional surgery and prolonged antibiotic treatment.[2]

  • For studies of hip and knee included in this guideline, the mean rate of infection was 2 percent.[3]

Elliot Abt, DDS, MS, MSc, who served as member of the AAOS-ADA work group on behalf of the ADA, pointed out that the review committee conducted a thorough review of existing clinical research published in the peer-reviewed literature.

"This guideline was based primarily on clinical research which examined a large group of patients, all having a prosthetic hip or knee and half with an infected prosthetic joint," said Dr. Abt, a general dentist in Skokie, Ill., and a member of the ADA Council on Scientific Affairs. "The research showed that invasive dental procedures, with or without antibiotics, did not increase the odds of developing a prosthetic joint infection."

This clinical practice guideline, with three recommendations, is based on a systematic review of the correlation between dental procedures and prosthetic joint infection (PJI).

  • Recommendation one, which is based on limited evidence, supports that practitioners consider changing their longstanding practice of prescribing prophylactic antibiotics for patients who undergo dental procedures. Limited evidence shows that dental procedures are unrelated to PJI.

  • Recommendation two addresses the use of oral topical antimicrobials (topical antibiotic administered by a dentist) in the prevention of PJI in patients undergoing dental procedures. There is no direct evidence that the use of oral topical antimicrobials before dental procedures will prevent PJI.

  • Recommendation three is the only consensus recommendation in the guideline, and it supports the maintenance of good oral hygiene.

"Research is always changing and we need to work to improve clinical research databases, so in the future any type of prospective research done in this area will help shed light on prophylaxis and orthopaedic infection rates," Dr. Jevsevar said.


'/>"/>

Contact: Lauren Pearson Riley
pearson@aaos.org
847-384-4031
American Academy of Orthopaedic Surgeons
Source:Eurekalert

Related medicine news :

1. Researchers find evidence of banned antibiotics in poultry products
2. Report says new evidence could tip the balance in aspirin cancer prevention care
3. More Evidence Bilingualism Aids Thinking Skills
4. Novel biomarkers reveal evidence of radiation exposure
5. Antiretroviral treatment for preventing HIV infection: an evidence review for physicians
6. WSU study finds overwhelming evidence of hidden heart disease in hypertensive African-Americans
7. Study shows no evidence medical marijuana increases teen drug use
8. Study of Retired NFL Players Finds Evidence of Brain Damage
9. New evidence for link between obesity and circle of friends
10. Cochrane finds no reliable evidence on effectiveness of electric fans in heatwaves
11. Study Gives First Evidence That Adult Human Lungs Can Regrow
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... 2017 , ... The American Board of Family Medicine's (ABFM) Board of Directors ... Officer, succeeding Dr. James C. Puffer upon his retirement. Dr. Newton will serve in ... retirement at the end of 2018. Upon assuming the role of President and CEO ...
(Date:10/13/2017)... ... October 13, 2017 , ... PurhealthRX , a leading Health and Nutrition ... the Purzorb™process to full spectrum CBD oil will revolutionize the rapidly growing CBD market ... can be easily incorporated into liquid products, while reducing costs to end users. , ...
(Date:10/13/2017)... , ... October 13, 2017 , ... Lori R. Somekh, ... member of ElderCounsel, a national organization of elder law and special needs planning attorneys. ... and rules. It also provides a forum to network with elder law attorneys nationwide,” ...
(Date:10/13/2017)... ... October 13, 2017 , ... Many families have long-term insurance ... care insurance companies have a waiver for care if the client has a cognitive ... the family pays for care, is often waived, so the benefits from their insurance ...
(Date:10/13/2017)... NY (PRWEB) , ... October 13, 2017 , ... Ellevate ... people in business to advocate for action towards gender equality at their inaugural Summit ... from around the globe, and reached a social audience of over 3 million. To ...
Breaking Medicine News(10 mins):
(Date:9/25/2017)... , Sept. 25, 2017  EpiVax, Inc., a ... design, and immune-engineering today announced the launch of ... development of personalized therapeutic cancer vaccines. EpiVax has ... exclusive access to enabling technologies to the new ... will lead EpiVax Oncology as Chief Executive Officer. ...
(Date:9/22/2017)... 22, 2017 AVACEN Medical (AVACEN) announced that ... successfully helping those with the widespread pain associated with ... Amanda in Essex, England commented, ... hair, experiencing no sleep at all, tremendous pain, with ... cannot recommend [the AVACEN 100] enough, how this has ...
(Date:9/18/2017)... , Pa. and KALAMAZOO, Mich. , ... Allentown, Penn. , and OptiMed Specialty Pharmacy of ... business partnership to offer a strategic hub service that ... Healthcare,s highly sought-after personal spirometer, Spiro PD 2.0, and ... A spirometer is a medical device used to ...
Breaking Medicine Technology: